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Wirksamkeit psychoonkologischer Interventionen auf die Lebensqualität der Patienten

Ein systematischer Überblick über Reviews und Metaanalysen

Effectiveness of psychological interventions with cancer patients – a review of meta-analyses

Abstract

Cancer patients are subject not only to physical strain but also to substantial psychological and social stress as well as major threats and challenges. Based on systematic reviews and metaanalyses, this paper provides a critical overview of the current state of the art on the efficacy of psychosocial interventions aiming to reduce cancer patients' distress and to enhance their quality of life. A variety of psychoeducational, cognitive-behavioral and psychodynamically oriented interventions, in an individual or a group setting was demonstrated to effectively reduce anxiety and depression in cancer patients of various tumour sites and stages of the disease. However, stronger effect sizes were only shown when targeting patients at increased distress levels and with longer duration of treatment. Relaxation, hypnosis and guided imagery all proved effective in reducing the experience of pain as well as side-effects during chemotherapy and radiotherapy. In addition, consumer reports show high satisfaction of patients with psychosocial support programs. In spite of the evidence of the beneficial psychosocial effects several questions arise from the findings, such as whether the effects remain stable over time, whether or not psychotherapeutic interventions differ with regard to their specific effects, and how interventions can best be translated from research into the real-world of cancer care.

Zusammenfassung

Psychosoziale Interventionen orientieren sich an den körperlichen, seelischen und sozialen Belastungen im Gefolge von Krebserkrankungen mit dem Ziel, die Lebensqualität von Krebspatienten zu verbessern oder zu erhalten. Die vorgestellte Arbeit vermittelt einen Überblick über den aktuellen Forschungsstand kontrollierter Studien zur Wirksamkeit psychosozialer Interventionen hinsichtlich der Verminderung von körperlichen und psychischen Symptomen als Krankheits- bzw. Behandlungsfolge und der Verbesserung der Lebensqualität. Kognitiv-behaviorale und psychodynamisch orientierte expressiv-supportive Einzel- oder Gruppenpsychotherapien verringern in allen Krankheitsphasen effektiv Ängste und depressive Symptome. Höhere Effektstärken werden bei initial starker Belastungsausprägung und mit längerer Behandlungsdauer erreicht. Entspannung, hypnoide, imaginative und übende Verfahren verringern wirksam körperliche Beschwerden, wie Schmerz, Übelkeit und Erbrechen. Consumer-Report-Studien zeigen, dass teilnehmende Patienten mit professioneller psychosozialer Unterstützung hoch zufrieden sind. Offene Fragen betreffen die differenzielle Wirksamkeit verschiedener Verfahren, die Konstanz von Therapieeffekten im Langzeitverlauf, den Nutzen von paar- und familienorientierten Interventionen, und die Übertragbarkeit der Forschungsergebnisse in die klinische Versorgung.

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Correspondence to Wolfgang Söllner.

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Söllner, W., Keller, M. Wirksamkeit psychoonkologischer Interventionen auf die Lebensqualität der Patienten. Psychosom Konsiliarpsychiatr 1, 249–257 (2007). https://doi.org/10.1007/s11800-007-0066-0

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Key words

  • cancer
  • distress
  • psycho-oncology
  • psychotherapy
  • quality of life
  • outcome

Schlüsselwörter

  • Krebs
  • Psychoonkologie
  • Psychotherapie
  • Lebensqualität
  • Effektivität
  • Angst
  • Depressivität